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The Maternal and Child Survival Program
Acting to End Preventable Maternal Mortality
CORE Group Global Health Practitioner Conference April 16, 2015
www.mcsprogram.org
Vision Statement Self-reliant countries equipped with
the analytical tools and effective systems enabling them to be on track to end preventable child and maternal
deaths
USAID’s flagship Maternal and Child Survival Program
Awarded: Launched June 2014 Length: 5 Years Funding Ceiling: 500 Million AOR: Nahed Matta Alternates: Malia Boggs; Megan Rhodes Technical Advisors: Karen Fogg; Kerry Ross
Program Basics
Maternal & Newborn Health
Child Health & Immunization
Family Planning Nutrition Malaria Water, Sanitation, &
Hygiene (WASH) HIV/TB
Technical Areas
Cross-Cutting Issues
Quality Innovation Partnerships (private sector, civil society, etc.) Gender Equity Measurement and Analytics Behavior Change Communication e/mHealth Community Approaches WASH Health Systems Strengthening
Evolution since MCHIP Reflects changing global RMNCH landscape and shifts in USAID priorities
Greater emphasis on cross-cutting issues such as quality, equity, and gender
Focuses on sustainable scale up, such as strengthening health systems, that will deliver high impact technical interventions
20% of MCSP funds are required to be spent “through local institutions”
Strategic Objectives Support countries to increase
coverage and utilization of evidence-based, high-quality reproductive, maternal, newborn and child health (RMNCH) interventions at the household, community and health facility levels;
Close innovation gaps to improve health outcomes among high-burden and vulnerable populations through engagement with a broad range of partners; and
Foster effective policy, program learning and accountability for improved RMNCH outcomes across the continuum of care
Integrated Themes Scaling up RMNCH coverage in 24 priority countries Maximize potential for public and private sector—including
civil society Addressing equity through a community health strengthening
approach Strengthening integrated community health platforms Integrating services across the continuum of care Better care on the Day of Birth Maternal newborn health and infectious disease Rigorous focus on monitoring, evaluation, and learning
24 Priority USAID Countries
Other countries where MCSP works:
Burma, Egypt, Guinea, Namibia, South Africa
Countries where MCSP works
Afghanistan Bangladesh Democratic
Republic of Congo
Ethiopia Ghana Haiti India Indonesia
Kenya Liberia Madagascar Malawi Mali Mozambique Nepal Nigeria Pakistan Rwanda
Senegal South Sudan Tanzania Uganda Yemen Zambia
Translating the Vision into Action
• Enabling and Mobilizing Individuals and Communities • Improve behaviors and norms, equity
• Advancing Quality, Respectful Care • Integration of maternal health and family planning • Scale up quality maternal health care • Address indirect causes of maternal mortality, poor birth
outcomes • Increase focus on maternal morbidity and disability • Respectful Maternity Care and improving work environment
• Strengthening Health Systems and Continuous Learning • Health systems strengthening, data use, innovation and research
Enabling and Mobilizing Individuals and Communities
• Improve individual, household, and community behaviors and norms • Community engagement, advocacy • Strengthening community-based counseling and
empowerment of community health workers • Improve equity of access to and use of
services by the most vulnerable • Reaching rural populations with uterotonics for
prevention of postpartum hemorrhage
Integrated Community Health Platforms A flexible system for
integrated RMNCH service delivery in the community, spanning common gaps in the continuum of care from household to health facilities
CHW Workforce and Community Infrastructure
Information for Equity, Learning and Adaptation
Institutionalization, Coordination
and Partnerships
Intervention Package:
Preventative, Promotive &
Curative Services
Support Services and Functions
(commodities, supervision, information processes…)
National Policy and Support
Includes health promotion, disease prevention, care seeking and treatment Not a one-
size-fits-all blueprint
Advancing Quality, Respectful Care
• Integration of maternal services & family planning • Postpartum family planning as essential component of
both antenatal and postnatal care • Scale up quality care
• Comprehensive approach to prevention of postpartum hemorrhage
• Address indirect causes of maternal mortality and poor birth outcomes • Infectious disease management as critical component
of antenatal care
Advancing Quality, Respectful Care
• Averting and addressing maternal morbidity and disability • Prevention and management of obstetric fistula
• Advance choice and respectful maternity care (RMC) • RMC: Bangladesh, Mozambique, South Sudan, Tanzania,
Rwanda, Kenya, Ethiopia, Haiti, Indonesia, Madagascar, Burma, Nigeria
• Alternative birth positions: Ethiopia, Mozambique, Burma, Pakistan, Rwanda, South Sudan, Tanzania
Address Gender Issues
• Antenatal care (ANC) • Engagement of men in counseling & birth planning • Gender-based violence (GBV): identification, safety planning
& harm reduction, counseling re effects on MCH outcomes • Labor and birth
• Respectful and gender-sensitive care during birth • Deploying female skilled birth attendants (SBA) • Making services affordable to women • Bringing SBA to women who lack mobility or transport • Participatory women’s groups to foster social support for
maternal and neonatal health problems
Strengthening Health Systems and Continuous Learning
• Systems to track stock-outs of life-saving drugs
• Human resources for health • Clinical governance and focus on
measurement as driver for improving quality and coverage of services
• Strengthen maternal death surveillance • Operations research and learning agenda
Multidimensional Management Antenatal
Care
DISTRICT
FACILITY
COMMUNITY HEALTH STRATEGIES
COMMUNITY /HOUSEHOLD
Intrapartum Care and
Emergencies
Postpartum and Newborn
Care
CLINICAL GOVERNANCE
BETTER CARE ON THE
DAY OF BIRTH including CEmONC
STRENGTHENED ANTENATAL
CARE including infectious
disease (ID)
STRENGTHENED POSTNATAL
CARE including FP, nutrition, ID
Strengthen Maternal Death Surveillance and Response
• Technical assistance for capacity-building of key elements of MDSR in 10 countries • Kenya, Ethiopia, Tanzania, Yemen, Nigeria, Malawi,
Zambia, Rwanda, Uganda, and Egypt
• Engage with global stakeholders developing and integrating MDSR/PDSR Systems • Collaboration with the USAID Africa Bureau and
WHO-AFRO
Support & Study Scale-Up
Four high impact technical interventions, each in multiple countries (e.g., misoprostol)
Monitor clear outcomes on ongoing basis
Use clear implementation strategies
Standardized process documentation
Active Community of Practice
Supporting countries to eliminate preventable deaths: Implementation Research to drive better practice in “real time”
Sustainable impact at scale
Service expansion / increased coverage
Inst
itutio
naliz
atio
n in
hea
lth s
yste
ms Short cycle learning to improve
practice & achieve scale
check
adjust
learn
check
adjust
learn
check
adjust
learn
check
adjust
learn
Adapted from: Institute for Reproductive Health (IRH)
Acknowledgements
• Ali Abdelmegeid • Kate Brickson • Myra Betron • Stephanie Suhowatsky • Cicely Thomas
For more information, please visit www.mcsprogram.org
This presentation was made possible by the generous support of the American people through the United States Agency for International Development (USAID), under the terms of the Cooperative Agreement AID-OAA-A-14-00028. The contents are the responsibility of the authors and do not
necessarily reflect the views of USAID or the United States Government.
facebook.com/MCSPglobal twitter.com/MCSPglobal
Pregnancy Labor & Delivery Newborn Child
TECHNICAL APPROACHES ACROSS LIFE CYCLE
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Integrated Community Platforms
Whole Market District Approach
ANC/PNC and Day of Birth Integrated
Interventions
Integrated Child Health Interventions
(incl. prevention, immun., nutri.)
“PRACTICE – LEARNING FEEDBACK LOOP”
Helping Countries Eliminate Preventable Child & Maternal Death, by Achieving Impact at Scale for Women and Children